Image Credit: © tsuguliev - stock.adobe.com

At Fetch Nashville, Heidi Lobprise, DVM, DAVDC, delivered a presentation titled, “They Are NOT Too Old for Dental Procedures (Usually).” Lobprise’s talk focused on treating older pets with periodontal disease, and she discussed the tailored pain management and anesthesia protocols that veterinarians should undertake to reduce treatment risks for older animals. This talk took place in Davidson Ballroom 103C in the Music City Convention Center, in Nashville, Tennessee, from 4:00 to 5:00 PM on Friday, May 30,

Why do many dogs not receive ongoing dental care throughout their lives?

Lobprise started off her presentation by addressing the leading root cause for older patients afflicted with periodontal disease. Lobprise explained that most pet owners do not routinely bring their pets to the veterinarian for routine dental checks. The result is that dental disease and chronic inflammation continue to build over time as the pet ages, leading to further complications once the pet enters their senior years.

“If you have cumulative changes, particularly if there hasn’t been ongoing care, that’s when you start having issues,” Lobprise said during her talk.

She added that pets not receiving dental care throughout their lives tend to develop comorbidities that become more pronounced with age, and it makes their care later in life much more difficult.

The objective of Lobprise’s talk was to help veterinarians better understand the systemic impact of chronic inflammation of dental disease.

Heidi Lobprise’s talk at Fetch Nashville focused on providing veterinarians with important information about pain management and anesthesia protocols for older pets with certain comorbidities. Photo Credit: Will Wetzel

What are the challenges of senior dentistry?

Senior dentistry care is often more challenging because senior pets are dealing with more ailments than younger animals. Most senior pets often have gum disease, oral tumors, comorbidities, depleted reserves for healing, and increased incidence of tooth resorption. All these factors, as well as others, influence the patient’s anesthesia risk, which can dictate their individual treatment plans.

Lobprise also talked about the stigma surrounding anesthesia. She mentioned that it isn’t only the associated risks with anesthesia that make pet owners anxious but also the costs.

“The cost of anesthesia is always a big concern that comes up often,” Lobprise said in her talk.

The bulk of Lobprise’s talk concentrated on “inflam-aging,” which is described as chronic, low-grade inflammation.

“Inflam-aging is correlated with most age-related diseases,” Lobprise said in her talk.

 “When we go to the doctor, we are normally told...diet and exercise...resolve our comorbidities. But inflam-aging is extremely complex. It’s more than diet and exercise. It’s a snowball effect.”

Because senior pets have 1 or several comorbidities, anesthesia risks are increased. As a result, Lobprise explained that preoperative evaluations are essential in assessing the risk and determining what targeted therapies can help stabilize the patient.

“When assessing a patient’s comorbidities, we have to ask: Is it moderate enough that the animal can get through anesthesia OK?” Lobprise said in her talk.

To determine a patient’s ability to handle anesthesia, the ASA Physical Status Scale is often used. Lobprise explained all 5 classes of this scale, mentioning that most of her patients are usually designated as class II, with some falling in class III.

In the second half of Lobprise’s talk, she provided a list of general best practices during preoperation patient care, including things to consider for pets with cardiac disease considerations, renal disease considerations, diabetes considerations, liver disease considerations, and pain management. Below are some of the highlights:

Preoperation patient care: For medications, Lobprise explained that she refrains from prescribing ACEI but recommends anxiolytics and most cardiac drugs. She also said in her talk that if the pet has a “history of regurgitation, I like getting them on antiacid medication 2 to 3 days ahead of time.”

Cardiac disease considerations: Lobprise preoxygenates the pet if possible before the operation, recommending to also avoid routine use of anticholinergics. To support the animal further, a lower fluid rate might be needed. ACEI is also discouraged, and she recommends refraining from using it in the days leading up to the operation.

Liver disease considerations: Glucose levels need to be monitored closely, and it is important that the patient is still eating well.

Pain management: Stress reduction is often critical for anesthesia procedures. As a result, preanesthetic anxiolytics may be recommended to help calm a patient’s anxiety leading up to the operation.

Lobprise concluded her talk by discussing best practices for the operation and the recovery period post operation. She highlighted the importance of a good technician during the operation.

“The best monitor is a good technician,” Lobprise said in her talk.

 “Having someone dedicated to watching the patient during anesthesia is extremely critical.”

Lobprise added that a technician can monitor a patient’s vital signs while the veterinarians and surgeon are concentrated on their specific responsibilities, alleviating their stress during this period.

For the recovery period, Lobprise discussed how patient management is very important. Mortality and morbidities become obvious during the recovery phase. It is important that fluids are watched and monitored carefully and to ensure that the patients do not injure themselves.

Lobprise H. They are NOT too old for dental procedures (usually). Presented at: Fetch dvm360 conference; May 30, 2025; Nashville, TN. 

Articles

Heidi Lobprise, DVM, DAVDC, discusses the benefits of addressing chronic periodontal disease in older animals by employing “pet-alized” care.

The importance of dental care for older animals

Microorganisms such as bacteria, fungi, viruses, archaea and protozoa, have a critical role in the health of animals. In a lecture at the 2025 Fetch dvm360 Conference in Nashville, Tennessee, Vicky Ograin, MBA, RVT, VTS (Nutrition), scientific communication senior specialist with Hill's Pet Nutrition, discussed the gastrointestinal microbiome and how it can be modulated with prebiotics, probiotics and postbiotics.

“Prebiotics are dietary fibers that feed beneficial gut bacteria, enhancing microbial diversity. Probiotics are beneficial microorganisms introduced into the body to restore microbial balance, support immune health, and improve gut integrity. Postbiotics are metabolites like short-chain fatty acids (SCFAs) and polyphenols produced by gut bacteria during fermentation of dietary fibers,” Ograin noted in her presentation.

Karen Shenoy, DVM, vice president and chief veterinarian for Hill’s EMEA at Hill’s Pet Nutrition, noted that the microbiome is a collection of microbes and all kinds of different organisms that are throughout our body, in 

 at the 2025 Veterinary Meeting & Expo in Orlando, Florida

. She further explained the importance of a healthy microbiome in the interview.

“We talk the most about the gut microbiome, and you hear about how what's in your gut and how the different microorganisms that live there can affect you system-wide. It can affect all kinds of different organ systems, and is really important in health and disease that we're thinking about keeping the gut microbiome, not just ourselves, but our microbes that live within us and within our pets good and healthy,” Shenoy said.

As an example of how the gut’s microbiome can affect health, Ograin shared with Fetch attendees the story of her cat, Slick. “I adopted a kitten, and in about a year and a half of age, he was diagnosed with glomerulonephritis,” Ograin said.

A renal condition, glomerulonephritis is inflammation of the glomeruli, microscopic structures in the kidney that filter out toxins such as waste products. Although there are medication therapies, management of the disease may also include special diets and omega-3 fatty acid supplementation.

In the case of Slick, Ograin explained, the kitten was initially given a prognosis of about 2 months to live. However, she inquired with Slick’s veterinary team about the possibility of using nutrition to help manage the disease and a diet that promoted renal health was suggested. Slick was put on a kidney diet combined with medications and subcutaneous fluids.

“I caught it really early, but he was stage 4 renal disease when he was diagnosed, and he lived 10 years. In the end, he pretty much was just on the kidney diet and subcutaneous fluids. And so hopefully that shows you the power of nutrition,” Ograin said.

Ograin explained the prebiotics are fibers that “feed” the gut’s microorganisms and equated them to “beneficial bacteria.” They produce SCFAs such as butyrate and are a source of polyphenois provide nutrients to the microbiome. In short, “prebiotics are probably one of the most important things that we can make sure that our dogs and cats, and us, are taking in to our body, so it helps with the microbial diversity,” she said.

Although research is needed to further ascertain the benefits of probiotics for felines and canines, Ograin said, their efficacy has been linked to the unique conditions of each host. Therefore, not all probiotics will have the same effects on every host or every species.

“So you've got the intestinal lining, and when you take in a probiotic, the goal of that beneficial bacteria is to adhere to the lining of the intestinal tract and to colonize, make more beneficial bacteria, because that's really where you're going to recolonize and get that population of bacteria back up again,” Ograin said.

Lastly, postbiotics are the metabolites produced by bacteria during fermentation, according to Ograin. They include SCFAs and polyphenols. “Postbiotics are believed to contribute to the health benefits offering support for gut health, antioxidant, anti-inflammatory effects or even potentially be selectively antimicrobial. In other words they spare the good bugs and selectively limit the pathogenic ones,” Ograin said.

In conclusion, imbalance of the microbiome can contribute to various health conditions. Although further research is needed, prebiotics, probiotics and postbiotics are all beneficial to the gut microbiome and support gastrointestinal health.

“There's so much more that we need to learn, so we are just starting to really get the tip of the iceberg of all the things that the microbiome is associated with. It really affects every part of our body,” Ograin said.

Ograin V. The microbiome: a dynamic ecosystem. Presented at: Fetch dvm360 Conference; May 30-31, 2025. Nashville, Tennessee.

Shenoy K, Crossley KC. What the microbiome means for pet health. 

. February 4, 2025. Accessed May 30, 2025. 

https://www.dvm360.com/view/what-the-microbiome-means-for-pet-health

Williams K, Ward E, Panning A. Glomerulonephritis in cats. VCA Animal Hospitals. 2022. Accessed May 30, 2025.

Vicky Ograin, MBA, RVT, VTS (Nutrition), discussed the gastrointestinal microbiome and how it can be modulated with prebiotics, probiotics and postbiotics.

Feeding a pet's microbiome

Lone star tick. (Photo: ondreicka/Adobe Stock)

“The confluence of environmental, ecological, sociological, and demographic factors has created a near “perfect storm” leading to more ticks in more places,” said Kathryn E. Reif, PhD, MSPH, quoting a statement from the Entomological Society of America, during her session titled “No Room for Roommates: Kicking Ticks and Other Parasites to the Curb,” at the Fetch dvm360 Conference in Nashville, Tennessee.

 With tick populations rapidly expanding throughout North America, including in the United States, these parasites are increasingly posing a risk to pets year-round. 

“This is especially true in our own states and even more local in our own neighborhoods [and] communities,” Reif said.

 “Tick species that we may not have had to think about, or their associated pathogens, 10 [to] 20 years ago—[these] ticks are on the move, and they're moving into our neighborhoods and communities, posing new risks to our pets and to ourselves.” 

Ticks live an average of 3 years, explained Reif during her canine-focused lecture on various parasites and their treatment options.

The adult tick commonly found on dogs is the largest on average, with an age of 2 to 3 years old. 

Ticks have 3 main life stages: They hatch from eggs as larvae, molt into nymphs, and then molt once more into adults. At each life stage, the parasite takes 1 blood meal, which equates to approximately feeding once over several months to once every year. The 4 major tick species consist of the lone star tick (

The lone star tick is an aggressive tick species that is expanding quickly throughout the US. “This is a very aggressive tick species that's rapidly expanding out from the southeast part of the US, expanding westward, [and] now moving very aggressively northward,” Reif said. “This is a tick on the move.” 

According to Reif, the lone star tick is now present in the southern part of the Great Lakes of North America up to Maine. It has also been spotted in southern Canada. 

This parasite, as Reif explained, will “bite anything with a pulse.” “If you are alive and you have blood, consider yourself fair game for this tick species,” she said. She also emphasized that this particular tick species is one of the most difficult ones to kill and advises veterinary professionals to look at the data or label number on tick-control products to ensure that that specific product is effective against lone star ticks. 

Like the lone star tick, American dog tick populations are also expanding across the US, with the CDC reporting a higher number of counties in the eastern half of the country with an established American dog tick population.

This tick species is most frequently found in tall, grassy meadows; open woods; and open fields in agricultural areas.

“Certainly, the most infamous tick we have in the US is the blacklegged tick, or the deer tick,” Reif said. These ticks are most known for being vectors of 

, the bacterium responsible for Lyme disease. 

Meanwhile, the brown dog tick sets itself apart from the other 3 tick species by living inside and around homes. “They can cause massive infestations in homes and kennels. They live in your walls. They come out. You go to sleep one night—it's a normal night—the next day, you wake up, [and] the wall is crawling black. That's what these ticks do,” Reif said. 

During her session, Reif emphasized that ticks are now posing a risk to pets throughout the year, including during the colder months. This is especially true for certain species. 

“Some tick species even thrive when it's cooler or colder,” Reif said. She explained that the adult life stage of blacklegged ticks “thrive” during cooler or colder temperatures, and they hibernate during warmer weather. According to Reif, the life stage in blacklegged ticks most associated with Lyme disease and Anaplasmosis transmission in dogs is their adult stage. 

“So, we really do have temperatures that foster tick activity. Thus, our pets are at risk for tick activity—maybe not 365 days of the year, but certainly 12 months of the year,” Reif said. 

Reif K. No Room for Roommates: Kicking Ticks and Other Parasites to the Curb. Presented at: Fetch dvm360 Conference; May 29-30, 2025; Nashville, TN.

ESA position statement on tick-borne diseases. Entomological Society of America. June 27, 2019. Accessed May 30, 2025. https://www.entsoc.org/sites/default/files/files/Science-Policy/2019/EntSocAmerica_PolicyStatement_TickBorneDiseases-2019.pdf 

American dog tick surveillance. CDC. May 15, 2024. Accessed May 30, 2025. https://www.cdc.gov/ticks/data-research/facts-stats/american-dog-tick-surveillance.html 

Where do we find ticks? Companion Animal Parasite Council. Accessed May 30, 2025. https://capcvet.org/guidelines/ticks/americanum.

“Some tick species even thrive when it's cooler or colder...and actually hibernate when it gets too warm outside,” Kathryn E. Reif, PhD, MSPH, said during her Fetch dvm360 Conference session in Nashville, Tennessee.

The rise of ticks

What to know about communicating to clients about parasite control compliance

Client education and compliance

According to Kathryn E. Reif, MSPH, PhD, selecting the right parasite control strategy starts with knowing what parasites and associated diseases pose the greatest threat in a pet’s environment. Reif discusses how veterinarians can use regional data and owner behavior to guide product selection and improve long-term adherence and outcomes.

: We have a lot of different options available to us when it comes to parasite control products for our pets. Pet owners often want to know, “What product should I choose?” The first thing I want to emphasize is that most pet owners—truly the vast majority—are looking for a recommendation from their veterinarian.

Another helpful tool to guide these decisions is understanding the local parasite pressure. We can utilize resources like the Companion Animal Parasite Council (CAPC) prevalence maps to identify common parasites in our neighborhoods and regions. These maps are also helpful when considering travel plans; many pets accompany their owners on trips, and CAPC maps can provide insights into parasite risks in those destination areas as well.

For tick control specifically, I always encourage veterinarians to review the labels of the products they’re recommending. You want to make sure that the most common tick species in your area are actually covered. For instance, in the Northeast or Upper Midwest, 

—the black-legged tick or deer tick—is the most relevant. In the Southeast, the lone star tick is one of the most aggressive and dominant species.

Knowing which tick species are prevalent in your area helps guide both product selection and disease awareness. Many tick-borne diseases—like Lyme disease, anaplasmosis, and ehrlichiosis—can present with similar clinical signs, so identifying the likely culprit is important.

Ultimately, when determining the best parasite control product for a given pet, the answer may not always feel definitive. The best product is the one that the pet owner will most use. Whether it’s a monthly or extended-duration product, consistent and proper use is what truly determines effectiveness.

Videos

Kathryn E. Reif, MSPH, PhD, explains why CAPC prevalence maps and tick species awareness can guide veterinarians in choosing the most appropriate parasite control products based on local and travel-related exposure.

Local parasite prevalence and client adherence are key for deciding which parasite control product to prescribe

Fetch Nashville officially commenced at the Music City Convention Center in Nashville, Tennessee. The Fetch conference kicked off with a keynote address delivered by Julia Miller, DVM, DACVD, on Friday, May 30, from 9:15–10:15 am. Her keynote address, billed as a musical journey of discovering one’s passions through veterinary medicine, chronicled her path from studying opera and theater at Indiana University to becoming a veterinarian.

Julia Miller, DVM, DACVD was the star of the show at dvm360’s Keynote Presentation, where she talked about her career trajectory and some of the most important lessons she learned. Photo Credit: dvm360 team.

Miller’s keynote was truly a musical journey. As she shared the story of her career—punctuated by the various “dreams” she got to live—she incorporated musical performances inspired by Broadway productions (

), and Nashville’s iconic country stars, such as Shania Twain.

Her “dreams” included pursuing opera at Indiana University, earning her veterinary degree from Cornell University, joining the Cornell faculty, working in mixed-animal general practice, and ultimately settling into her current role in private practice at Animal Dermatology Clinic in Louisville, Kentucky.

Some of her renditions included (but were not limited to):

“Man, I Feel Like a Horse Vet” (Shania Twain’s 

“What Can I Say Except It’s Scabies” (Dwayne Johnson’s 

Veterinary-themed versions of Journey’s 

Julia Miller, DVM, DAVCD (left) greets Dr. Adam Christman, DVM, MBA, at Fetch Nashville in the Music City Convention Center. Photo Credit: Bob Alaburda, dvm360 associate editorial director

After sharing her career story, Miller transitioned into the second half of her keynote: her 5 “Down and Dermy” tips, drawn from her experiences in dermatology.

If it’s itchy, it’s probably scabies.


Miller explained that pruritus is one of the most common dermatologic complaints, and clinicians should always consider scabies as a differential diagnosis early on.

Cytology is a dermatologist’s best friend.


“Cytology allows you to see your baseline impression, and it really does change what you do with your dermatology cases,” Miller said.¹ “This goes for rechecks as well. First appointments can get really busy, and you may not have the time you want. But when that dog comes back, you have to do something different. This goes back to my mantra: if you don’t succeed, you missed something. Do your diagnostics.”


“There are a lot of dermatologic diseases out there, and it can feel overwhelming,” Miller noted. “If you can get a really good description of the lesions—what they look like and where they are—you can narrow down your differentials.”


“Dermatology is a visual sport,” Miller said. “A physical description is good, but a picture is worth more than 1,000 words.”¹
She added that photos are helpful not only for clinicians but also for clients, who can see the pet’s progress over time.


Miller emphasized the importance of injecting joy into the day-to-day, particularly given the repetitive nature of dermatology.

“I think it's also important to love our patients and our clients,” she said.¹ “When you see a cat with the best angry resting face you’ve ever seen, take a picture of it. Do the things that bring you joy. Yes, it can get monotonous—we see the same things over and over—but finding those moments in your day reminds you why you love the profession.”

A core message of Miller’s keynote was that most veterinarians won’t follow a clear-cut career path.

“My path was far from straight,” she said. “It was incredibly windy.”¹

Miller’s journey to discovering dermatology mirrors that of many aspiring country music artists who come to Nashville seeking success. Through twists, turns, and various jobs, they learn more about themselves—and what they’re meant to do.

“When change needs to happen, it needs to happen,” Miller concluded.¹

Discovering the delights of dermatology: One woman’s journey into derm and how you will learn to love it too!

 Presented at: Fetch dvm360® Conference; Nashville, TN. May 30, 2025.

Julia Miller, DVM, DACVD, discusses how her career in veterinary medicine led to her discovery of her passion for dermatology

A musical journey in discovering dermatology

Cytology is an important part of day-to-day life in practice, but it can be considered a challenge, plus some veterinary schools might not have taught this to students adequately. Because of this, some general practitioners may not feel confident in their skills when it comes to cytology.

During her lecture, "Lymph Node Cytology for General Practitioners" at the 2025 Fetch Nashville conference in Nashville, Tennessee, Kate Baker, DVM, MS, DACVP (Clinical Pathology), founder and chief pathologist at Pocket Pathologist, shares practical tips that general practitioners can use in practice when it comes to lymph node cytology. 

“I do want to first start by just saying, no matter how long you've been in practice, this is something that is difficult for everybody but does not have to be as difficult as it feels. There are a lot of ways to simplify cytology so that it can be something that you feel comfortable doing in practice,” Baker kicked off her lecture with.

“So I just want to give you that permission and that confidence already if you need it, because it's one of those things that after teaching this for almost 10 years now that I see time and time again, people saying I suck at cytology, but I have to do it, and I understand how that feels,” she continued.

Regarding lymph node cytology, Kate Baker, DVM, MS, DACVPM (Clinical Pathology), the biggest issue veterinary professionals have is broken cells. Baker utilized a video submitted by an oncologist where she explains that for the cytology being done for lymph nodes, the subject in the video is removing the syringe off the needle and putting the needle in the lymph node. Then, she stacks the needle around in a few other directions, withdraws it, and checks to see if there are contents in the hub of the needle. Then, the needle is reattached to the syringe, and then putting it onto the slide.

“She's distributing the contents onto several slides because she has quite a bit to spread it out. Because the second thing that we don't want to have in the cytology world are samples that are too thick, so we want to reduce the amount of cell lysis, and we want to spread the sample out,” explained Baker.

Baker emphasized the most important thing here is to not press down. She explained that she understands that things move fast in the clinic and professionals might not be fully paying attention and then just push and spread. However, she warned to not put any downward pressure on the slide, even if you think you are not you could be, so it is important to pay attention because it will help reduce cell lysis.

There are also obviously other things surrounding the lymph nodes that professionals could potentially hit on accident. One common occurrence Baker noted seeing often is veterinary professionals submitting a salivary gland sample thinking it was a lymph node, and although finding it fun, she offered some tips to help understand what the salivatory gland looks like and told attendees it is no big deal, and to not feel embarrassed.

In a salivary gland, there are epithelial cells, which have a glandular appearance to them, and within them is bony saliva. However, you may not get good tissue like the ones that she discussed during her lecture, and it's possible to just get some proteinaceous stuff in the background.

“A clue that you hit the salivary gland is [the] lining up of cells that are called windrowing. So does anybody come from a farming family? Every time we pass a field that has their hay lined up in windrows, I just geek out because I'm like, ‘Oh it's windrows.’ So that's what windrowing is. It's a borrowed term from farming, where they line the hay up and rows,” said Baker.

“We use that term too and see how these red blood cells are kind of moving along in one direction. So that is when you have cells suspended in a viscous material. And saliva is viscous, so that is something that you may see, even if you don't catch these salivary gland epithelial cells,” continued Baker.

A final important note that Baker included is she does see people trying to interpret broken cells and accidentally diagnose a patient with lymphoma because they don’t realize they are looking at the broken cells.

Cytology can be a daunting thing to tackle as a general practitioner, especially if you did not learn a lot about it in veterinary school. However, lymph node cytology is a great tool that veterinary professionals can utilize in their practices so understanding some of the basics involved in the process and having dos and don'ts can save time, resources, and more for veterinary practices and patients.

Baker K. Lymph Node Cytology for General Practitioners. Presented at: Fetch dvm360 conference; Nashville, TN. May 30-31, 2024.

Kate Baker, DVM, MS, DACVP (Clinical Pathology) explained that although cytology can be challenging, it might be easier than you think.